A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Dry cough

Hyperkalemia

Hypotension

Angioedema

Answer and Explanation

The Correct Answer is A

Choice A reason: ACE inhibitors cause dry cough by inhibiting bradykinin breakdown, which accumulates and irritates the airways. ARBs block angiotensin II receptors without affecting bradykinin, eliminating this side effect. This makes ARBs a suitable alternative for patients experiencing cough, confirming this as the correct choice.

Choice B reason: Hyperkalemia occurs with both ACE inhibitors and ARBs due to reduced aldosterone production, which decreases potassium excretion. Both drug classes affect the renin-angiotensin-aldosterone system similarly, so switching to an ARB does not eliminate this risk, making this choice incorrect for the question.

Choice C reason: Hypotension is a shared side effect of ACE inhibitors and ARBs, as both reduce blood pressure by inhibiting the renin-angiotensin system. ARBs block angiotensin II receptors, causing vasodilation similar to ACE inhibitors, so this side effect persists, making this choice incorrect.

Choice D reason: Angioedema, though rare, can occur with both ACE inhibitors and ARBs. While less common with ARBs, it’s not eliminated, as it may result from mechanisms beyond bradykinin accumulation. Switching to an ARB doesn’t guarantee avoidance of angioedema, making this choice incorrect.

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Correct Answer is C

Explanation

Choice A reason: ACE inhibitors are teratogenic, risking fetal harm, so monitoring while continuing is unsafe. Stopping the drug is critical, making this incorrect for safe pregnancy management.

Choice B reason: ARBs are also contraindicated in pregnancy due to similar teratogenic risks. Switching to an ARB is not safe, so this is incorrect compared to stopping the medication.

Choice C reason: ACE inhibitors can cause fetal abnormalities, so the patient must stop the medication and contact her provider immediately for safer alternatives. This is the correct action.

Choice D reason: Continuing ACE inhibitors, even adjusted, is dangerous in pregnancy due to teratogenicity. Immediate cessation and provider consultation are required, making this incorrect.

A. Selectivity B. Safety C. Effectiveness D. Irreversible action E. A recognizable trade name

Correct Answer is ["A","B","C"]

Explanation

Choice A reason: Selectivity ensures a drug targets specific receptors, minimizing side effects. This is a key property of an ideal drug, making it a correct choice.

Choice B reason: Safety is critical, ensuring the drug causes minimal harm at therapeutic doses. This is a fundamental ideal drug property, so it is correct.

Choice C reason: Effectiveness ensures the drug achieves its intended therapeutic effect. This is essential for an ideal drug, making it a correct choice.

Choice D reason: Irreversible action is not ideal; reversible effects allow control and safety. The ‘Big Three’ focus on efficacy, safety, and selectivity, so this is incorrect.

Choice E reason: A trade name aids marketing but is not a pharmacological property. Effectiveness, safety, and selectivity are primary, so this is incorrect.

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A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

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